No-shows and missed appointments are a silent profit-killer. Industry studies put the average dental no-show rate at 15 %, with some practices seeing as high as 30 % adit.com. Even a single empty chair can cost 45-60 minutes of production time. Below is a step-by-step system –drawn from Unique Dental Scheduling’s experience with 400 + practices – to keep your schedule full, and your patients happy.
Why No-Shows Matter and What Causes Them
Knowing the pain points and what causes them can keep chairs full and patients cared for.
Common Problems
- Reminders never arrive or feel like spam, so patients forget
- Long lead times prompt patients to book elsewhere for an earlier slot
- Anxiety triggers last-minute cancellations
- Last-minute hurdles such as transportation or childcare
Impact on the practice
- Lost production time and wasted staff hours
- Reduced access for patients who are ready for care
- Damage to online reputation when would-be patients encounter long waits
Baseline Strategy – Automate Confirmations First
Here’s a guide for how to automate your reminders – the best and easiest way to get started.
- Sync your practice-management software (PMS) with an email/SMS reminder platform (most modern PMS modules or vendors like Adit, NexHealth, Weave, or Modento integrate in minutes).
- Reminder cadence that works:
- 7 days out: “Save the date” email with directions and an “Add to Calendar” link.
- 48 hours out: SMS + email with one-tap “YES to confirm / R to reschedule.”
- Morning-of: Quick SMS plus a link to pre-visit paperwork, if needed.
- Escalate when you don’t get a confirmation:
- Phone call 48 hours out if no digital confirmation.
- Second call or voicemail next day reminding the patient that a confirmation is required to keep the slot.
- Confirm cell numbers and email addresses at every patient encounter to keep data accurate.
Pro-tip: Use UDS for Confirmation Calls
It can be hard for your team to make sure manual confirmation calls are up to date. If your office struggles with this, we can help with our confirmation system:
- 24 or 48 hours before the visit our team scans your schedule for unconfirmed patients.
- Live agents call each patient, confirm or reschedule, and leave clear notes directly in your PMS.
- Your front desk stays free to focus on in-office guests while enjoying the benefits of personal outreach.
It is a simple, set-and-forget system that consistently nudges those last few stragglers back onto the calendar.
Availability Is a Key Factor for Patients in Pain
When a patient is hurting, every extra hour feels like an eternity–and they’ll keep calling around until someone can ease the pain right away. Build in flexibility to capture these urgent cases: keep a couple of prime-time “relief slots” open each day exclusively for patients in discomfort and train your team to offer next-day appointments for less severe but still painful issues like cracked fillings or lingering sensitivity.
Or if you cannot place a patient in pain right away, add them to an automated waitlist so the moment a cancellation pops up they receive an instant alert and can be worked in as soon as possible.
Level Up – Personal “Concierge” Call After Booking
Calling within 24 hours of the initial booking converts a time slot into a genuine commitment:
- Build rapport: “Hi Sarah, this is Nicole from Bright Smiles. Dr. Patel asked me to personally thank you for choosing us–do you have any questions before your visit on Tuesday?”
- Set up how the experience will go: Outline parking, insurance verification, and average chair time.
- Uncover barriers early: Transportation, childcare, dental anxiety, or financial concerns can all be solved before they lead to a no-show.
Many offices that add this step see show rates climb with outreach because patients feel known and accountable. On top of reducing no-shows, patients feel like they are valued and cared for, too.
For the Offices That Really Need It – Reservation Deposits for High-Value Slots
Some offices have experienced success in charging a no-show fee or taking pre-visit deposits. A recent MGMA survey found that practices charging a modest no-show fee improved attendance 25 % in 2024 compared with 16 % for those that did not mgma.com. No-show fees typically range from $25-$100, and can help cover the costs that patients impart on the practice when they fail to show up.
Pre-treatment deposits can help move the needle in the right direction, too. Taking a deposit anywhere from $50-$200 upfront that will be used toward treatment can help ensure patients show up.
Bonus Tips From 400 + Offices
We found some common keys to successes from some of our partner practices:
- Implement a real-time waitlist so last-minute cancellations are auto-offered to eager patients.
- Overbook low-risk slots by 5 % once you have solid historical data.
- Flag chronic no-shows in your PMS and require same-day deposits or limited booking windows.
- Offer membership plans that bundle preventive visits – members skip less because they have already paid.
- Send value-based content (e.g., brushing tips, whitening promos) between visits to keep your practice top-of-mind.
Measure, Tweak, Repeat
Take note of how to put an idea into practice:
- Track two stats monthly:
- Show Rate = Kept ÷ Scheduled
- Confirmation Rate = Confirmed ÷ Scheduled
- Segment by appointment type and provider to spot patterns.
- Adjust the text and cadence of messages to help improve response rates.
- Track successes and challenges and adjust.
Making it Happen
- Automate reminders first – it is the cheapest lift.
- Add a concierge call to create a personal bond and answer questions early.
- For high-value or chronically missed slots, use deposits to ensure mutual commitment.
- Always measure results; your data will tell you where to tighten the process next.
Ready to fill every chair? Unique Dental Scheduling can plug into your existing phones and PMS in days, bringing the playbook above–and the live agents to run it – to your practice. Let’s talk.